Stanford Hamstring MRI Grading & Prognostication Tool

📖 BAMIC Scheme

Binkert et al. Figure 2 — PubMed

📊 Bradley Grade

Bradley Table 1 — PubMed

🔢 Bradley MRI Score

Bradley Table 2 — PubMed

1 Classification Mode

Choose scope before grading

a) BAMIC only

Any skeletal muscle. Uses BAMIC site + extent criteria only (Pollock 2014; Binkert et al.).

b) BAMIC + Bradley

Hamstring injuries only. Adds the Bradley traditional grade (Table 1) and modified categorical MRI score (Table 2), validated in professional footballers.

2 Patient Demographics & Anatomic Site

Bradley & Clinical Factors

Athlete Age: 24 years (Bradley Table 2: 1 pt)

≤ 25 y (1 pt) 26-31 y (2 pts) ≥ 32 y (3 pts)

Laterality

Right

Left

Hamstring Muscles Involved: 1 muscle (1 pt) (Select all that demonstrate high signal / injury)

Biceps Femoris (Long)

Biceps Femoris (Short)

Semitendinosus

Semimembranosus

Craniocaudal Location (BAMIC site descriptor — Pollock 2014; also scored in Bradley Table 2)

Proximal

1 pt

Middle

2 pts

Distal

3 pts

Tendon Insertion / Origin Involvement (Bradley Table 2)

0 pts

Yes

2 pts

Unable to Continue / Removed From Activity? (observational factor; McAuley 2022)

Yes

Associated with longer RTS; not an additive rule

No / Continued

3 BAMIC Site & Morphological Measurements

Pollock 2014 & Binkert Fig 2

Overall Injury Category

Grade 0a

Normal MRI (Focal Pain)

Grade 0b

DOMS / Patchy Soreness

Grade 1 - 4

Acute Structural Injury

BAMIC Anatomical Site / Subtype: (Determines 'a', 'b', or 'c' suffix)

'a' - Myofascial

Peripheral / Fascial border

'b' - MTJ / Muscular

Central / Musculotendinous

'c' - Tendinous

Intratendinous (≥Grade 2c)

Intratendinous Extent (required for 2c versus 3c): Pollock tendon length and maximal tendon diameter criteria

Tendon injury longitudinal length

≤ 5 cm

Grade 2c range

> 5 cm

Grade 3c range

Maximal tendon diameter involved

≤ 50%

Grade 2c range

> 50%

Grade 3c range

Complete Full-Thickness Disruption / Avulsion (Grade 4):

No (Grades 1 - 3)

Yes (Grade 4 / 4c)

Full thickness gap / avulsion

1. Transverse Edema / Cross-Sectional Area (CSA %): < 10% (Gr 1)

< 10%

BAMIC 1 | Brad 1pt

10 - 25%

BAMIC 2 | Brad 1pt

> 25 - 50%

BAMIC 2 | Brad 2pt

> 50 - 75%

BAMIC 3 | Brad 2pt

> 75%

BAMIC 3 | Brad 3pt

2. Longitudinal Edema / STIR Signal Length: < 5 cm (Gr 1)

< 5 cm

BAMIC 1 | Brad 1pt

5 - 10 cm

BAMIC 2 | Brad 2pt

> 10 - 15 cm

BAMIC 2 | Brad 3pt

> 15 cm

BAMIC 3 | Brad 3pt

3. Architectural / Fiber Disruption Length: 0 cm / Strain (Gr 1)

0 cm / Strain

No visible fiber gap

< 1 cm

BAMIC 1 | Minimal

1 - 5 cm

BAMIC 2 | Moderate

> 5 cm

BAMIC 3 | Extensive

Bradley Traditional Fiber Disruption Width (Bradley Table 1):

Grade I (Strain)

No visible fiber disruption

Grade II (Low-Grade)

< 50% fiber width disruption

Grade III (High-Grade)

≥ 50% width / complete disruption

Tendon / Muscle Retraction (Bradley Table 2):

None (0 cm)

0 pts

< 2 cm

1 pt

≥ 2 cm

2 pts

🏆 "HIGHEST GRADE WINS" LIVE RESOLVER Pollock 2014 & Binkert Fig 2

Transverse CSA < 10% cross-section Grade 1

Longitudinal Length < 5 cm length Grade 1

Fiber Disruption No fiber disruption Grade 1

All parameters in Grade 1 range → BAMIC Extent Grade 1

Classification & Scoring Summary Mild Injury

BAMIC Grade

Small MTJ Tear

Bradley Grade

Grade I

Strain (No Disruption)

Modified Categorical Bradley MRI Score

4 / 19 pts

Cohort-Derived Score Band

0 to 1 Game

Age (≤25y):	1 pt
Muscles involved (1 muscle):	1 pt
Location (Proximal):	1 pt
Insertion involved (No):	0 pts
Cross-sectional injury* (<10%):	1 pt
Retraction (None):	0 pts
Long axis T2 signal (<5cm):	1 pt
TOTAL SCORE:	5 / 19 pts

*Cohen/Bradley Table 2 defines cross-sectional injury points only at discrete measured values (0/25/50/≥75%). This tool interpolates across continuous BAMIC-aligned CSA bands to derive this point value — not a verbatim reproduction of Table 2.

Report Draft

Education only. Classification and cohort-level prognosis must be verified by a qualified clinician and must not replace image review, examination, rehabilitation milestones, or multidisciplinary return-to-sport judgment.

1 Classification Mode

2 Patient Demographics & Anatomic Site

3 BAMIC Site & Morphological Measurements

Report Draft

Published References: BAMIC Scheme & Bradley Tables